DIURETIC DRINKS AS A WEIGHT LOSS TREND

The leading causes of death worldwide and in Türkiye include cardiovascular diseases, cancers, respiratory diseases, and diabetes—conditions closely related to nutrition and metabolism. One common risk factor among these diseases is obesity. Numerous studies indicate that changes in diet and lifestyle can improve human health. Alongside nutrition and physical activity goals, various weight loss products marketed as "slimming products" have emerged as modern solutions for weight management.

These plant-based products are particularly favored by women, creating a growing market demand. Today, herbal teas, coffees, and smoothies marketed with claims such as "fat-burning" and "edema-reducing/diuretic" have become widely accessible with just a click. However, are these products, often purchased based on recommendations from friends, relatives, or online sources, truly beneficial? Before discussing these claims, it is essential to define edema.

As is well known, about 60-70% of our body is composed of water. Most of this water is found inside our cells, while a portion exists outside the cells. When the fluid balance between these compartments is disrupted, excess fluid accumulation can lead to swelling in tissues or organs, a condition known as edema. Depending on its cause, edema can occur in the hands, face, arms, legs, feet, and ankles. The affected skin often appears tight and shiny.

1. Dietary factors: Inadequate protein and calorie intake, insufficient water consumption, excessive salt intake, and high alcohol/tea/coffee consumption
2. Sedentary lifestyle, prolonged sitting or inactivity
3. Hormonal changes: PMS (premenstrual syndrome), pregnancy, and menopause
4. Chronic health conditions: Heart failure, nephrotic syndrome, cirrhosis, and other major kidney, liver, and heart diseases
5. Circulatory and lymphatic issues: Conditions such as cellulitis and lymphedema
6. Medications: Some blood pressure medications, antidepressants, antivirals, chemotherapy drugs, hormone medications, certain diabetes medications, NSAIDs (e.g., aspirin)
7. Allergic reactions: Urticaria, angioedema

As seen, edema has multiple causes. So, what exactly are diuretic drinks?

Diuretic drinks are beverages made from plants, vegetables, and fruits believed to help eliminate excess water from the body. The diuretic (water-removing) effect of these plant-base drinks is primarily due to phytochemicals, which are active compounds responsible for their unique color, aroma, and taste. Examples include alkaloids, flavonoids, saponins, triterpenoids, glycosides, and nitrates.

These drinks help reduce water retention in two main ways:

1. Increasing blood flow, leading to blood vessel dilation.
2. Preventing the reabsorption of excess water and minerals (such as sodium, chloride, and potassium), facilitating their removal from the body.

To better understand diuretic drinks, they can be categorized into two main groups:

• Diuretic teas and coffees
• Fruit and vegetable-based juices

After water, hot tea and coffee are among the most consumed beverages worldwide. These drinks contain active compounds such as caffeine, catechins, flavonols, and diterpenes, which may aid weight control and obesity management. The most common herbs found in teas and coffees marketed as "diuretic," "weight loss aid," or "fat-burning" include:

• Green Tea: May support weight management by increasing fat burning. Its caffeine content also provides a diuretic effect.
• Cherry Stalk: High in potassium and flavonoids, offering a mild diuretic effect. Used in traditional Persian medicine for kidney stones.
• Heather Leaves: Rich in flavonoids, helps remove excess water, relieves constipation, and has antimicrobial properties.
• Rosemary: May support weight loss, regulates blood sugar, and lowers cholesterol.
• Yerba Mate: Contains caffeine, providing an energizing and diuretic effect. It may also relax blood vessels and support weight loss.
• Peppermint: Aids digestion and helps relieve bloating, nausea, and vomiting.
• Dandelion: Known for its diuretic properties, may help reduce bloating.
• Hibiscus: Rich in vitamin C, potassium, and antioxidants, may help lower blood pressure and cholesterol.
• Cinnamon: Known for its many health benefits. It reduces inflammation in the body, balances blood sugar, fights microbes, may help reduce cancer risk, and lowers cholesterol. Due to its diuretic effect, it may also be used as a diuretic.
• Turmeric: Contains curcumin, which reduces inflammation, supports digestion, regulates blood sugar, and helps prevent weight gain.

Fruits and vegetables, with their content rich in vitamins, minerals, and water, are preferred for supporting immunity and eliminating toxins and edema. For example, 100% fruit juices are rich in vitamins A, C, E, K, and B group vitamins, minerals like potassium, iron, manganese, fiber, and many active compounds. Therefore, fruit/vegetable juices, thanks to these components in their content, may provide protection against cancer, diabetes, cardiovascular, and nervous system diseases (such as Alzheimer’s and Parkinson’s diseases). In recent years, these juices, which are also sold in the form of smoothies with different combinations or prepared at home, feature the following main fruits/vegetables:

• Cucumber: High in potassium and water, helps remove excess fluids, reduce inflammation, and fight infections. Known for its antioxidant and analgesic properties, it may also relieve constipation.
• Spinach: Rich in nitrates and potassium, promotes blood circulation and eliminates excess fluids. It may also lower the risk of diabetes, cardiovascular diseases and cancer.
• Beetroot: It may lower blood pressure by dilating blood vessels with its nitrate compounds. Also, facilitates the delivery of oxygen to tissues and has positive effects on sports performance. It is rich in minerals such as potassium, magnesium, calcium, phosphorus, and iron.
• Watermelon: Contains over 90% water and is rich in potassium. With these properties, it may increase urine production without straining the kidneys. Additionally, it may lower blood pressure while protecting heart health.
• Lemon: With its beneficial compounds, it may improve metabolism, prevent insulin resistance, and facilitate weight loss with a proper nutrition plan. In addition to its diuretic effect for toxin elimination, it may also prevent the formation of kidney stones and gallstones with the citric acid it contains.
• Parsley: Removes excess water and sodium while preserving potassium.
• Celery: 95% water content, may help lower blood pressure and acts as a diuretic.
• Pineapple: Contains various vitamins and minerals, has bromelain, an enzyme that breaks down proteins. Due to these properties, it is used as a digestive aid and a diuretic.
• Red/Purple Berries: Berries such as strawberries, blackberries, raspberries, blueberries, and cranberries are rich in anthocyanins, a color pigment, vitamin C, water, and fiber. They have protective effects against type 2 diabetes, cardiovascular diseases, cancer, and nervous system disorders.

The main effects of these drinks consumed for the purpose of reducing edema can be summarized in four points:

1. Diuretic Effect: The caffeine, flavonoids, polyphenols, and potassium in these drinks may increase urine production.
2. Vasodilation: Some active compounds may relax blood vessels, improving circulation and fluid balance.
3. Anti-Inflammatory Effects: Edema can sometimes be caused by inflammation-based diseases (such as type 2 diabetes, metabolic disorders, cardiovascular diseases, kidney problems, rheumatoid arthritis, etc.). Foods with high antioxidant content, such as ginger, cinnamon, and red-purple fruits, may help reduce inflammation and assist in the elimination of edema.
4. Sodium-Potassium Balance: Potassium-rich fruits and vegetables help remove excess sodium and water.

Aside from these, the effects of these drinks on weight loss are not miraculous and are minimal when consumed alone. Therefore, for healthy weight loss, these drinks can be occasionally included in the routine under the supervision of a healthcare professional (doctor, dietitian, pharmacist), in addition to a personalized proper nutrition plan and regular physical activity.

• “They provide rapid and permanent weight loss.”
The fast weight loss associated with diuretic drinks is mostly due to water loss in the body and is not permanent. For more effective and sustainable weight loss, a personalized and proper nutrition plan combined with physical activity is essential.

• “Since they contain natural ingredients, anyone can consume them.”
Human studies on these drinks, which are marketed with various health claims, are limited, and their mechanisms of action are not fully understood. Therefore, their use may be unsafe for pregnant and breastfeeding women. Individuals with chronic conditions such as cardiovascular or kidney diseases who require regular medication should consult a healthcare professional before consuming such products. Since diuretic drinks contain components with “water-removing” effects, they may interact with blood pressure medications, diuretics, and blood thinners. This interaction may negatively affect medical treatment and lead to various side effects.

• “Since they are natural, they can be consumed in any amount and for an unlimited period.”
The fact that a product is entirely natural does not make it completely safe. One of the unresolved issues regarding such herbal drinks is the appropriate dosage and duration of use. In most cases, the amount of active compounds obtained from plants, fruits, or vegetables through diet is insufficient to observe their beneficial effects. As a result, people may consume these products excessively, believing in their natural content to achieve faster and more effective results. Frequent and high consumption may lead to allergic reactions such as skin redness, itching, and swelling, as well as mild side effects like nausea, vomiting, diarrhea, dizziness, and palpitations. In severe cases, it may cause liver and kidney damage.

• “They are free from chemicals, so they have a clean content.”
Just like in any other food category, food fraud is also encountered in herbal teas, coffee, and plant-based products. Recent inspections conducted by Turkish Ministry of Agriculture and Forestry have revealed the presence of pharmaceutical active ingredients, particularly in herbal teas and certain fruit juices. One such substance, sibutramine, was initially recommended for obesity treatment but was later banned by Turkish Ministry of Health due to its serious cardiovascular side effects, such as heart attack and stroke. Another critical issue is where these herbal products are purchased from. Many of these products are bought based on recommendations from acquaintances, herbalists, unregulated sales channels, or online platforms, where their supply conditions remain unknown. Poorly managed supply chains may lead to contamination with insects, parasites, fungi, pesticides, and heavy metal residues, potentially making the product more harmful than beneficial.

Edema occurs as a result of the disruption of the fluid balance between our cells. The causes of edema include inadequate nutrition, inactivity, hormonal changes, certain diseases, or medication use. The phytochemicals and minerals found in teas, coffees, fruit, and vegetable juices, which are thought to help eliminate excess water from the body and aid in weight loss, may play a supportive role against edema by increasing urine output, expanding blood vessels, and reducing inflammation. However, this effect is usually temporary, and the weight loss caused by the elimination of edema is not permanent. For more effective treatment, it is necessary to understand the underlying cause of the edema and act accordingly. For healthy weight loss, balanced nutrition and physical activity are the gold standard. Additionally, even though diuretic fluids are entirely natural, it does not mean they are safe for everyone, and excessive consumption may lead to side effects and interact with certain medications. Therefore, before purchasing such drinks, it is important to consult a healthcare professional and obtain them from reliable sources.